Scoliosis

Everyone's spine has curves. These curves produce the normal rounding of the shoulder and the sway of the lower back.

A spine with scoliosis has abnormal curves with a rotational deformity. This means that the spine turns on its axis like a corkscrew. Compare the more subtle curve of the normal spine to the severe curvature of the scoliotic spine.

Scoliosis is a curvature of the spine which may have its onset in infancy but is most frequently seen in adolescence. It is more common in females by a 2:1 ratio. However, when curves in excess of 30 degrees are evaluated, females are more frequently affected by a ration of approximately 8-10:1.

The cause of the most common form of scoliosis -- idiopathic scoliosis -- is unknown, but there are certainly hereditary factors that are present.

Scoliosis causes shoulder, trunk and waistline asymmetry. In mild forms, the condition may be barely noticed; whereas in severe forms there is significant disfigurement, back pain and postural fatigue, and it may be associated with heart failure. Fortunately the majority of scoliosis cases need only close follow-up to watch for worsening of the curve. Some cases require more aggressive treatment which could include surgery (see below).

Orthopedic surgeons are best qualified to evaluate and treat deforming spinal conditions like scoliosis. However, a good resource for further information is:

Non-Operative Treatment

The non-operative treatment of scoliosis involves observing the deformity with examinations and repeated x-rays. Under certain circumstances, when spinal growth remains, a brace may be used in combination with follow-up x-rays. Physical therapy exercises have not been shown to be effective treatment for scoliosis.

Why Surgery?

Surgical treatment of scoliosis may be indicated for any of the following reasons:

Unhealthy habits such as smoking and excessive alcohol intake are known risk factors. A regular regimen of improved physical activity, especially weight-bearing exercise or the use of resistance machines, can prevent or slow the loss of bone with aging.

It is important to tell your doctor if you detect any loss of height, have sudden back pain or suffer a fracture with little trauma. A medical workup would include a complete medical history, x-rays and blood and urine test. Your doctor can order a bone mineral density (BMD) test at AASTHA to detect low bone density.

Men and women who have risk factors should take calcium and, in some instances, Vitamin D, as a preventative measure. Additional treatments for osteoporosis now include calcitonin, which comes in a nasal spray, and bisphosphonate alendronate (Fosamax). Estrogen is the first line of defense against osteoporosis and the decision whether or not to take estrogen should be carefully considered with your doctor, who can recommend a specific program of treatment.